Differential plasmacytoid dendritic cell phenotype and type I Interferon response in asymptomatic and severe COVID-19 infection

PLoS Pathog. 2021 Sep 2;17(9):e1009878. doi: 10.1371/journal.ppat.1009878. eCollection 2021 Sep.

Abstract

SARS-CoV-2 fine-tunes the interferon (IFN)-induced antiviral responses, which play a key role in preventing coronavirus disease 2019 (COVID-19) progression. Indeed, critically ill patients show an impaired type I IFN response accompanied by elevated inflammatory cytokine and chemokine levels, responsible for cell and tissue damage and associated multi-organ failure. Here, the early interaction between SARS-CoV-2 and immune cells was investigated by interrogating an in vitro human peripheral blood mononuclear cell (PBMC)-based experimental model. We found that, even in absence of a productive viral replication, the virus mediates a vigorous TLR7/8-dependent production of both type I and III IFNs and inflammatory cytokines and chemokines, known to contribute to the cytokine storm observed in COVID-19. Interestingly, we observed how virus-induced type I IFN secreted by PBMC enhances anti-viral response in infected lung epithelial cells, thus, inhibiting viral replication. This type I IFN was released by plasmacytoid dendritic cells (pDC) via an ACE-2-indipendent but Neuropilin-1-dependent mechanism. Viral sensing regulates pDC phenotype by inducing cell surface expression of PD-L1 marker, a feature of type I IFN producing cells. Coherently to what observed in vitro, asymptomatic SARS-CoV-2 infected subjects displayed a similar pDC phenotype associated to a very high serum type I IFN level and induction of anti-viral IFN-stimulated genes in PBMC. Conversely, hospitalized patients with severe COVID-19 display very low frequency of circulating pDC with an inflammatory phenotype and high levels of chemokines and pro-inflammatory cytokines in serum. This study further shed light on the early events resulting from the interaction between SARS-CoV-2 and immune cells occurring in vitro and confirmed ex vivo. These observations can improve our understanding on the contribution of pDC/type I IFN axis in the regulation of the anti-viral state in asymptomatic and severe COVID-19 patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged, 80 and over
  • Asymptomatic Infections
  • COVID-19 / immunology*
  • Cell Line, Tumor
  • Dendritic Cells / classification*
  • Dendritic Cells / immunology
  • Dendritic Cells / virology
  • Epithelial Cells / cytology
  • Female
  • Hospitalization
  • Humans
  • Interferon Type I / immunology
  • Interferon Type I / metabolism*
  • Lung / cytology
  • Male
  • Middle Aged
  • Neuropilin-1 / metabolism
  • Phenotype
  • SARS-CoV-2 / immunology*
  • Severity of Illness Index
  • Toll-Like Receptor 7 / metabolism

Substances

  • Interferon Type I
  • TLR7 protein, human
  • Toll-Like Receptor 7
  • Neuropilin-1

Grants and funding

This work was financially supported by Istituto Superiore di Sanità (www.iss.it) and partly co-financed by the Italian Ministry of Health (grant GR-2016-02363749 to MS) and the European Union’s Horizon 2020 research and innovation programme, under grant agreement no. 874735 (VEO) to LB. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript and none of the authors received a salary from any of the funders.